Heartmate 3 Implantation in Cancer Survivors with Advanced Heart Failure

Abstract

There are over 15 million Cancer Survivors (CSr) in the United States and this number is estimated to increase further with improvement in cancer therapeutics and an aging population. In previous studies, CSr undergoing Left Ventricular Assist Device (LVAD) implantation were found to have worse outcomes than patients without a history of cancer. The aim of this study was to ascertain the effect of a previous history of cancer on adverse events and survival in patients undergoing HeartMate 3(HM3) implantation. 165 consecutive patients undergoing HM3 implantation from November 2014 to July 2019 were included. Baseline demographics, cancer history and survival data were obtained from electronic medical records. The CSr group were defined as those with a documented history of a non-skin cancer malignancy. The mean age of the overall cohort was 59± 13 yrs and 84% were male. The CSr group consisted of 21 patients (13%). Malignancies in the CSr group included a history of breast CA, lymphoma, leukemia, bladder CA, uterine CA, prostate CA, pancreatic CA, thyroid CA, sarcoma and head and neck CA. 5 of the CSr patients had a history of exposure to chemotherapy while 3 had been exposed to thoracic radiation. The CSr patients were older than the Non-CSr group (65.2± 12 vs 58.3± 13 yrs; p=0.01), with no significant difference in other baseline characteristics. There was no difference in survival between the CSr and Non- CSr (93.8% vs 89.3%; p=0.58) at one-year post HM3 implantation (Figure1). There was no difference in freedom from stroke (100%, vs 93.2% p= 0.20) or freedom from GI bleeding (78.8% vs 75.1% p= 0.74) between the two groups. CSr have equivalent survival after HM3 implantation compared to those without a history of cancer. Further study is needed to assess long term outcomes and complications in this cohort of patients.